NIH Funds First-Ever Study on Impact of Medical Marijuana on Opioid Use

A first-ever long-term study testing whether medical marijuana reduces opioid use among adults with chronic pain has just been funded by the National Institutes of Health (NIH). A five-year $3.8 millions grant for the study was awarded to researchers at Albert Einstein College of Medicine and Montefiore Health System.

The study will look at people who test positive for HIV because, according to Albert Einstein College of Medicine, this population has more chronic pain and opioid use compared to the general population. They note that between 25% and 90% of adults with HIV suffer from chronic pain, and adults with HIV are likely to receive opioids to help manage their pain. The study will also include 250 who test negatiev for HIV.

Now that 29 states and the District of Columbia have legalized the use of medical marijuana, many with HIV have access to medical marijuana because it is used to treat pain and to help alleviate other conditions that are prominent among adults with HIV.

“There is a lack of information about the impact of medical marijuana on opioid use in those with chronic pain,” says Chinazo Cunningham, M.D., M.S., associate chief of general internal medicine at Einstein and Montefiore and principal investigator on the grant. “We hope this study will fill in the gaps and provide doctors and patients with some much needed guidance.”

According to a press release from the organization, “researchers have never studied—in any population—if the use of medical marijuana over time reduces the use of opioids. Additionally, there are no studies on how the specific chemical compounds of marijuana, tetrahydrocannabinol (THC) and cannabidiol (CBD), affect health outcomes, like pain, function, and quality of life. Most studies that have reported negative effects of long-term marijuana use have focused on illicit, rather than medical, marijuana.”

“As state and federal governments grapple with the complex issues surrounding opioids and medical marijuana, we hope to provide evidence-based recommendations that will help shape responsible and effective healthcare practices and public policies,” Dr. Cunningham said.

The study will include 250 HIV-positive and HIV-negative adults with use opioids to manage chronic and who have received certification from their physicians to use medical marijuana. The medical marijuana will be dispensed through approved dispensaries in New York State. Over the course of 18 months, study subjects will complete online questionnaires every two weeks. The questionnaires focus on pain levels and the medical and illicit use of marijuana and opioids. They will also give urine and blood samples at in-person research visits every three months. In-depth interviews with a select group of these participants will explore their perceptions of how medical marijuana use affects the use of opioids.

I’m happy to hear the NIH has finally approved funding for medical marijuana, but sad that it’s focus is only on one select group. It’s a good FIRST step, but that only means it will be years, maybe decades before it could offer any hope for other chronic pain sufferers 🙁
I’ll be dead by then.

With the growing number of reported suicides. some with a final testimony of not being able to receive tolerable pain relief, martyred for the sake of others, , marijuana, medical is not for everyone. Patients would rather end……their lives as to resort to “illegal”, illicit substances in their respective states. I have NO DOUBT that cannabis has……a valid medical use.. I advocate for no “one” remedy for the patient with pain but, I do advocate for sufficient pain relief for the accused, “drug addict” patients.
People resorting to self termination because of insufficient medication is simply unacceptable. The “brains” are all attempting to find a single solution. A single solution for the millions that suffer with incurable, continuous pain, is not possible.Each patient….should be evaluated by a personal provider, physician, and let the experienced doctor make a determination of what may be……the better medication when and if opioid medication becomes the last resort for pain management. Who “knows” the patient better than the personal provider.
Continuous, unman aged pain is now an epidemic. An unnecessary epidemic. The mis-guide-line needs to be “tabled” for now. A more comprehensive,”reference” for prescribing physicians can be realized but, how long will it take? Patients are at “the end of their rope”. The decision to ” self terminate” rather than to resort to a “street drug” or illegal substance is proof, that these patients are only seeking legitimate, adequate, tolerable pain management prescribed through a licensed physician.
WAKE UP DOT.GOV. The responsibility for death, that is unnecessary, because of a mis-guided-line, a “reference” only for physicians to prescribe opioid medications does have “inconsistencies”, “gaps” for sufficient treatment and DOT.GOV is responsible for the untimely demise of legitimate patients with incurable, continuous pain.
Phone, write, e-mail your state ,medical “regulators”, your state representatives, even the President. The “opioid crisis” has caused an epidemic of worsened suffering and can be changed, rapidly. Terminate 90 mme daily, maximum and stop the unwarranted, unsubstantiated, unilateral reduction of medication to ALL patients with pain to a ridiculous low dosage that patients have been stably treated with…….for decades, prior to 90 mme, daily, maximum..
If cannibals does ease pain, then the use of it can be, is, beneficial to people that did not ask for a life in continuous pain.Other great uses of cannabis products are well known. if opioids are going to be “outlawed”, then lets use what nature…..provides.The stigma, with patients that are prescribed opioid medication is ridiculous. ANY person under constant pain bombardment , from a disease, a corrective surgery or surgeries, would use opioid medication if………it was the last option to manage pain. We, the pain patients KNOW what relentless pain does to us. We KNOW what the non pain people ……would do, to ease the pain but, our testimony, regardless of beneficial use in excess of 90 mme doesn’t count.
Blessed are those that have not experienced incurable pain……yet. If you can live your life without pain management, you are truly blessed. Young people, veterans, injured in the service of Americas Freedom are NOT receiving adequate pain management. Incurable, lifetime pain is a random health situation that can, does affect “good” people Jeff.Open your mind to someone else s health situation Jeff, it could and may be you or a loved one.

@Laura P Shulman
My pain consultant is head of Pain Management for 5 UK Teaching Hospitals and he recommends 50% Indika taken with 50% Sativa strains of cannabis for pain. I know one of his colleagues Dr Mick Serpell has published research on cannabis for pain. Serpell is based at Gartnavel Hospital Glasgow in Scotland if you wish to look it up. Whether patients can score this on the street is another matter!

Long time coming. If a natural plant, grown on this continent, been used for ? long but DOT.GOV has not “studied” the use of cannabis since prohibited. Sounds familiar. Study the plant, the properties that help with any……..all types of pain generating conditions. Word of mouth, evidence proc;iamed from users results , where it has been legalized as to the plants positove effects have to be proven scientifically. Crunch the numbers, publish the findings uniasedly and if honesty prevails……. legalize the plant use.. Whomever it helps, make the medication available. Wherever the answer for the people that experience, deal with everyday, consistent, incurable pain that have tried all means of pain mangement it’s a hopeful ,positive, indicator we hope DOT.GOV pays attention. Jeff said “good” people don’t use marijuana” but, I bet he would if he had farmed, built bridges, roads, worked as a firefighter, telephone repairman or even delivered maill…….all his life.
The unwarranted reduction/removal of effective opiod medication.through our “blackmailed “providers is having much more negative effects than expected, or cared about. Loss of hope is loss of life.Please, by all means. those with the authority, the credentials please find the postive propertires of herb so those that need it, can have it………soon.

In the U.K. Recently the government was presented with good quality research showing marijuana works as a chronic pain killer. Nonetheless they refused to legalise it. Medical marijuana is only legal for multiple sclerosis in the U.K. The Hippocrisy over this and alcohol – which is more harmful than heroin as Prof David Nutt The govt’s sacked drugs zsar s rightly said. Alcohol doesfar more social damage than any other ‘drug’. Ask any child of an alcoholic.

One thing that always gets my goat is how the Gov’t conviently “forgets” that it has had an ongoing, & current research program on the effects of smoking MMJ on glaucoma since the late ’60’s & THEY are the ones growing & distributing it monthly to the subjects! — I want to see the preliminary data results from that almost 50 yr study!

This is great. To bad it took so long for the medical field to accept mmj. The only bad part is how long it will take. Chronic pain patients need it now only because they are having their needed opioid meds taken away due to all drs. being scared to prescribe them!

It is about time. They are presenting this as a way to deal with addiction though. This kind of study is desperately needed but it has nothing to to with Addiction. They will very likely only find that Cannabis helps with sleep, and may reduce the need for Opiates in some participants. Cannabis Promoters are claiming that Cannabis is a substitute for Opiates, it may be for some. People have turned to Cannabis for Millennia for pain, it was widely available before the U.S Govt made it illegal.

I’m hoping this study will allow the participants to choose whichever cannabis strains work for them individually, rather than arbitrarily assigning a “study strain.” One of the beauties of today’s medical cannabis culture is the variety of cultivars available, each with its unique cannabinoid and terpene profile. Everyone’s personal chemistry is different, and that’s reflected in our unique response to the different components of the plant.

It’s difficult to rectify herbal medicine, which works on an individualized model, with modern allopathic medicine, which works on a “mass scale” model. I haven’t seen the study proposal, but I’m fantasizing about the possibility of marrying up the two….

This idea that cannabis can reduce opioid addiction has been obvious for years to anyone who has been open-minded about the field.

What scares me use the idea that cannabis can easily replace opioids. While addicts can easily replace opioids with cannabis and improve safety, pain patients cannot. Opioids aren’t dangerous when used under doctor supervision for pain control. Addiction rates are 0.03-0.4% for pain patients taking opioids for pain relief instead of euphoria. We don’t experience euphoria. Opioid addiction is all about dopamine, not mu-opioid.

Cannabis is a wonderful adjunct pain reliever, but for severe, chronic IP (Intractable Pain), nothing works like opioids (tramadol is not an opioid). Cannabis is not a replacement. It does, however, reduce addiction risk further. Methadone and NMDA drugs like Namenda, ketamine, & dextromethorphine all help reduce tolerance.

The most amazing part about cannabis combined with opioids is that cannabis is not only makes opioids mower effective,but cannabis is OPIOID SPARING!!! Cannabis allows you to reduce your opioid dose while maintaining or improving pain control. Cannabinoids allowed me to reduce my fentanyl from 17.2mg fentanyl (10.8mg around the clock plus 6.4mg actiq), 45mg/day methadone, and 180mg oxymorphone down to 7.2mg fentanyl per day & 0mg oxymorphone with slightly better pain control. Unfortunately, once my opioids were reduced beyond this, i faced diminished returns. Every patient had a minimum effective dose (magic dose) and they will suffer needlessly below this dose, but cannabis reduces this dose.

The trouble is we pain patients are constantly being made worse by stress from medical abuse from ignorant and incompetent practitioners, so will no doubt end up needing opioids AS WELL AS cannabis. Cannabis has separate pain receptors in the body than the ones for opioids, as far as is known. ALL 5 pain receptors need medicating in most pain patients, hence the need for a properly supervised drug cocktail. It is time the opioids hysteria died a death it is damaging too many pain patients. The real risk of addiction is only 1:3000 when taken for actual pain. NSAIDS are more dangerous with a 1:1400 risk of death! Only opioids given within two years of pain onset will prevent chronic pain becoming a permanent life long disability because they block the spinal receptors that cause chronic pain states. Think how much money that would save various governments! Nonetheless cannabis calms the whole nervous system reducing pain globally and increasing activities of daily living Hugely. Plenty of published research on this available in the UK